Fluticasone Furoate / Vilanterol Trifenatate

Breo Ellipta Inhaler

Breo Ellipta is an FDA-approved prescription inhaler used to treat chronic obstructive pulmonary disease (COPD) and asthma in adults. It combines fluticasone furoate, an inhaled corticosteroid that reduces airway inflammation, and vilanterol, a long-acting beta2-adrenergic agonist that relaxes airway muscles. The inhaler is designed for long-term treatment, helping to prevent breathing difficulties and manage symptoms. It is not intended for immediate relief of acute symptoms, for which a separate rescue inhaler is prescribed. Breo Ellipta is taken once daily and has specific dosages based on the condition being treated.

Product Overview

Breo Ellipta is a brand-name inhalation powder specifically designed for adults suffering from chronic obstructive pulmonary disease (COPD) and asthma. This dual-ingredient medication contains fluticasone furoate, an inhaled corticosteroid (ICS) that helps to decrease inflammation within the airways, and vilanterol trifenatate, a long-acting beta2-adrenergic agonist (LABA) that aids in relaxing the muscles around the airways to improve breathing.

The inhaler is used once daily and is available in two strengths: 100 mcg fluticasone furoate with 25 mcg vilanterol and 200 mcg fluticasone furoate with 25 mcg vilanterol. For asthma, the dosage can vary between these two strengths based on the severity of symptoms and individual response to treatment. The maximum recommended dosage for asthma is one puff of the 200 mcg/25 mcg strength per day. For COPD, the prescribed dosage is consistently 100 mcg/25 mcg once daily, which is also the maximum for this condition.

Breo Ellipta is designed for the long-term management of respiratory diseases and is not suitable for immediate symptom relief. For sudden breathing issues, patients are advised to use a quick-acting rescue inhaler like albuterol. The regular use of Breo Ellipta helps maintain a steady level of medication in the body, facilitating better long-term control of symptoms and reducing flare-ups. Patients with liver issues may require dosage adjustments and monitoring due to the corticosteroid content. It is essential to follow the healthcare provider’s instructions closely and discuss any side effects or concerns for optimal management of COPD and asthma.

Uses of Breo Ellipta 

It is approved to treat the following conditions in adults:

• Chronic obstructive pulmonary disease (COPD)
• Asthma 

How to Use Breo Ellipta?

Dosage

Breo Ellipta comes in the form of a powder inhaler and has three strengths:

• 50 mcg fluticasone furoate/25 mcg vilanterol
• 100 micrograms (mcg) fluticasone furoate/25 mcg vilanterol
• 200 mcg fluticasone furoate / 25 mcg vilanterol

Recommended Dosage for Different Patients

Dosage for Asthma Using Breo Ellipta

• Starting Dosage: Your doctor may prescribe Breo Ellipta in doses of either 100 mcg/25 mcg or 200 mcg/25 mcg. It is recommended to take your dose at the same time every day.
• Maximum Dosage: The highest recommended dosage for asthma is one puff of the 200 mcg/25 mcg formulation once per day.
• Dosage Adjustments: If you begin treatment with the 100 mcg/25 mcg dose and your asthma symptoms are not adequately controlled, your doctor may increase your dose. The goal is to find the lowest dose that effectively manages your symptoms to minimize the risk of side effects.
• Important Considerations: Breo Ellipta is not intended for the immediate relief of asthma symptoms. For sudden breathing problems between daily doses of Breo Ellipta, your doctor will prescribe a short-acting rescue inhaler, such as albuterol (brands include ProAir and Ventolin HFA).

Dosage for COPD Using Breo Ellipta

• Prescribed Dosage: The recommended dosage for treating COPD with Breo Ellipta is 100 mcg/25 mcg once per day. This is the maximum allowable dosage for COPD treatment with this medication.
• Administration Advice: It is essential to take your dose at the same time each day to effectively manage your COPD symptoms.
• Additional Treatment for Symptoms: If you experience shortness of breath between your daily doses of Breo Ellipta, your doctor will prescribe a short-acting rescue inhaler for immediate relief. An example of such a medication is albuterol.

Long-term Treatment with Breo Ellipta

• Usage Overview: Breo Ellipta is generally prescribed as a long-term treatment option. If your doctor deems it safe and effective, you will likely use it for an extended period.

Dosage Adjustments

• Considerations for Liver Function: Breo Ellipta’s inhaled corticosteroid (ICS) component may have a heightened effect in individuals with liver problems. If you have reduced liver function, your doctor will closely monitor you for corticosteroid-related side effects, such as increased susceptibility to infections.

[Note: These recommendations may vary from person to person. Discuss them with your doctor; they’ll customize your dosage accordingly.]

How to Take It?

• Breo Ellipta is provided as an inhaler that includes two blister packs for each dose. Each inhaler typically contains either 14 or 30 doses. One blister pack contains fluticasone furoate powder, while the other contains vilanterol powder.
• Carefully read the dosing instructions that accompany your medication. These instructions are crucial for proper use.
• The manufacturer also offers additional information to help you understand how to properly dose and use Breo Ellipta. Below are summarized steps for using your Breo Ellipta inhaler effectively.
  • Step 1: Prepare the Medication for Inhalation: Slide the cover of the inhaler downward until you can see the mouthpiece. You will hear a clicking sound, and the dose counter will decrease by one (for instance, changing from 30 to 29). There is no need to shake the inhaler before using it.
  • Step 2: Breathe in the Medication: Hold the inhaler away from your face and exhale fully. Then, place your lips around the curved mouthpiece. Inhale sharply and deeply through your mouth only, not through your nose. After inhaling, remove the inhaler from your mouth and hold your breath for about 3 to 4 seconds. Finally, exhale slowly and gently.
  • Step 3: Clean the Inhaler and Rinse Out Your Mouth: If necessary, wipe the mouthpiece with dry tissue and replace the cover. Afterward, rinse your mouth with plain water, but do not swallow the water. Rinsing helps prevent the development of oral thrush, a fungal infection.
• Consistent Timing for Taking Breo Ellipta: It’s beneficial to take Breo Ellipta at the same time each day. This helps maintain a consistent level of the medication in your body, allowing it to work effectively.
• Assistance with Prescription Labels: If you find it difficult to read your prescription label, consult your doctor or pharmacist for help. Many pharmacies provide labels in large print, braille, or with a scannable code that converts text to speech through a smartphone. If these options are not available at your local pharmacy, your doctor or pharmacist may be able to suggest another pharmacy that offers these accessibility features.

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

How Does Breo Ellipta Work?

Breo Ellipta is designed to improve breathing by relaxing the muscles in your airways. It is used to treat chronic obstructive pulmonary disease (COPD) and to help reduce the frequency of symptom flare-ups in COPD patients. It also helps prevent asthma attacks in adults. COPD and asthma can cause your airways to narrow during flare-ups, making breathing difficult. The narrowing of the airways can be caused by several factors, including:

• Muscle spasms within the airways.
• Accumulation of fluid or sputum (mucus).
• Constriction of blood vessels in the lungs.

Breo Ellipta addresses these issues, helping to keep the airways open and reducing the severity of breathing problems. It contains two active ingredients: fluticasone furoate and vilanterol trifenatate. Fluticasone furoate is an inhaled corticosteroid (ICS), while vilanterol trifenatate is a long-acting beta2-adrenergic agonist (LABA).

• Fluticasone Furoate (ICS): The exact mechanism by which fluticasone improves COPD and asthma symptoms is not fully understood. However, inhaled corticosteroids are known to reduce inflammation (swelling) in the airways, which likely contributes to their ability to control symptoms of COPD and asthma.
• Vilanterol Trifenatate (LABA): This component works by relaxing the muscles around the airways in the lungs, making it easier to breathe.

Important Safety Information

Side Effects

Mild side effects of Breo Ellipta may include:

• Voice loss
• Pneumonia
• Fever
• Abnormal heart rhythm (heartbeat that’s irregular, too fast, or too slow)
• Respiratory infections such as the flu or common cold
• Inflammation (swelling) in lung airways
• Esophageal thrush or oral thrush (fungal infection in your mouth or throat)
• Back and joint pain
• Headache
• Cough
• Sore throat
• Urinary tract infection (UTI)

Serious side effects of Breo Ellipta may include:

• Hypokalemia (low potassium levels). Signs may include:
  • Muscle cramps
  • Fatigue
  • Constipation
  • Weakness
  • Heart palpitations (feeling of extra or skipped heartbeats)
• Stunted growth in teens and children
• Heart-related problems like changes in heart rhythm or blood pressure. Signs may include:
  • Abnormal heart rhythm (heartbeat that’s too fast, too slow, or irregular)
  • Chest pain or pressure
  • Fainting
  • Lightheadedness or dizziness
  • Shortness of breath
• Pneumonia. Signs may include:
  • Shortness of breath
  • Fever
  • Chest pain
  • Cough (or coughing up mucus)
• Oral thrush or esophageal thrush (fungal infection in your mouth or throat). Signs may include:
  • Trouble swallowing
  • Dry skin at the corners of your mouth
  • Painful white bumps in your mouth
• Adrenal suppression (low cortisol levels). Signs may include:
  • Less of an appetite
  • Muscle weakness
  • Skin that appears darker
  • Tiredness
• Hypercorticism (high cortisol levels). Signs may include:
  • Acne
  • Bruising easily
  • Rounder face
  • Slow-healing cuts or wounds
  • Weight gain, mainly around your upper back and midsection
• Lower bone density. Signs may include:
  • Slouch posture
  • Back pain
  • Bone fractures
  • Loss of height
• Hyperglycemia (high blood sugar level). Signs may include:
  • Blurry vision
  • Fatigue
  • Feeling thirstier than normal
  • Headache
  • Urinating often
• Cataracts and glaucoma (eye problems). Signs may include:
  • Headache
  • Nausea and vomiting
  • Eye pain
  • Clouded or blurred vision
  • Sensitivity to light and glare
  • Seeing “halos” around light
  • Trouble seeing at night
  • Blind spots

[Note: This list may not cover all possible side effects. Always consult with your healthcare provider for medical advice about side effects.]

Warnings

Before starting treatment with Breo Ellipta, discussing your complete health history with your doctor is essential. Breo Ellipta may not be suitable for everyone, especially if you have certain medical conditions that could interact negatively with the drug. These interactions between the drug and health conditions are known as drug-condition interactions. Other personal health factors can also influence whether Breo Ellipta is a safe and effective treatment option for you. Consider the following factors and discuss them with your doctor:

• Heart conditions: Breo Ellipta may lead to heart-related side effects, including a fast or irregular heart rate and elevated blood pressure. If you have pre-existing heart conditions, such as heart failure or high blood pressure, using Breo Ellipta could potentially worsen these issues. It is crucial to discuss any heart conditions with your doctor before beginning treatment with Breo Ellipta. Your doctor will evaluate your health history and determine whether this medication is safe for you.
• Allergic Reactions: If you have previously experienced an allergic reaction to Breo Ellipta or any of its ingredients, inform your doctor. In such cases, your doctor will likely advise against using Breo Ellipta and may recommend alternative medications that are safer for your specific allergies.
• Osteoporosis: Using Breo Ellipta for an extended period could lead to decreased bone density, which results in weakened bones. If you have osteoporosis, informing your doctor before starting treatment with Breo Ellipta is important, as this medication may worsen your condition. Your doctor will assess whether Breo Ellipta is safe for you based on your health status and other medications you may be taking. If your doctor decides that Breo Ellipta is appropriate for your treatment, they may suggest more frequent monitoring of your bone health during the course of the medication.
• Eye problems: Using Breo Ellipta may lead to eye-related issues, including glaucoma and cataracts. If you already suffer from these conditions, using Breo Ellipta could potentially exacerbate them. It is essential to discuss any pre-existing eye problems with your doctor before initiating treatment with Breo Ellipta. Your doctor will evaluate your situation and determine whether this medication is safe for you.
• Increased Risk of Infection: Using Breo Ellipta can heighten your susceptibility to infections. This risk is particularly significant if you have a weakened immune system or are already prone to infections. If you are experiencing an infection or showing symptoms of one prior to starting Breo Ellipta, it is crucial to inform your doctor. They will likely address and treat your infection before prescribing Breo Ellipta.
• Diabetes: Breo Ellipta may lead to elevated blood sugar levels, which could exacerbate diabetes. Before initiating treatment with Breo Ellipta, discuss with your doctor how it might affect your diabetes. They may recommend more frequent monitoring of your blood sugar levels while you are using this medication to ensure they remain controlled and within a safe range.
• Liver Problems: Breo Ellipta is metabolized by your liver. If you have liver issues, your body may not effectively break down this medication, potentially leading to an accumulation of the drug in your system. This accumulation can increase your risk of experiencing side effects. If you have liver problems, informing your doctor before starting treatment with Breo Ellipta is vital. Based on the severity of your liver condition, your doctor may adjust the dosage of Breo Ellipta accordingly. They will also likely monitor you more closely for any side effects related to the medication. This careful management helps to ensure your safety while using Breo Ellipta.

Precautions

• Do not use Breo Ellipta if you are allergic to fluticasone, vilanterol, or milk proteins. These allergies can lead to serious reactions.
• Fluticasone, a component of Breo Ellipta, can suppress your immune system. This suppression can make you more susceptible to new infections or exacerbate existing ones. Inform your doctor about any recent or current infections or illnesses you’ve experienced in the past few weeks.
• Health Conditions: To ensure Breo Ellipta is safe for you, it is crucial to tell your doctor if you have any of the following conditions:
  • Diabetes
  • Glaucoma or cataracts
  • Heart disease, high blood pressure
  • Liver disease
  • A seizure
  • A weak immune system
  • Any type of infection (fungal, parasitic, bacterial, or viral)
  • Osteoporosis
  • A thyroid disorder
• Long-term use of steroids, like those in Breo Ellipta, may contribute to bone loss (osteoporosis), particularly if you smoke, are inactive, or your diet lacks sufficient vitamin D or calcium. A family history of osteoporosis also increases this risk. Discuss with your doctor how you can manage and mitigate these risks.
• The effects of Breo Ellipta during pregnancy are not fully understood. Untreated or uncontrolled asthma in pregnancy can lead to complications such as low birth weight, premature birth, or eclampsia—a condition characterized by dangerously high blood pressure that can cause serious health issues for both mother and baby. It’s essential to weigh the benefits of treating asthma with the potential risks to the unborn baby. Talk to your doctor about the safest options for managing your asthma during pregnancy.
• The safety of using Breo Ellipta while breastfeeding has not been established. Consult your doctor to understand potential risks and make the safest choice for you and your baby.
• Breo Ellipta is not approved for individuals younger than 18 years old. When considering treatment options, always follow the approved age guidelines.
• It’s crucial to have open and ongoing discussions with your healthcare provider about these considerations to ensure the safe and effective use of Breo Ellipta.

Other Important Precautions

• Alcohol Consumption: While Breo Ellipta itself does not interact with alcohol, be aware that some alcoholic beverages contain sulfites, which could potentially trigger COPD flare-ups or asthma attacks. If you consume alcohol, it’s important to discuss with your doctor how much is safe for you to drink, given your condition.
• Pregnancy: The safety of using Breo Ellipta during pregnancy is not fully established. Although animal studies have shown some risk of birth defects, these findings do not always predict human responses. If you are pregnant or planning to become pregnant, it is crucial to discuss with your doctor the potential risks and benefits of using Breo during this time.
• Breastfeeding: The presence of Breo Ellipta in human breast milk has not been conclusively studied. However, other inhaled corticosteroids similar to fluticasone furoate, a component of Breo, have been detected in breast milk. Before starting breastfeeding, discuss with your doctor the potential benefits and risks of using Breo. This discussion will help you make an informed decision about whether to use this medication while breastfeeding. 

In all cases, a thorough conversation with your healthcare provider will help determine the best course of action based on your specific health needs and circumstances.

Missed Dose

• Take the missed dose as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and proceed with your regular dosing schedule.
• Do not take a double dose to make up for a missed one. The manufacturer advises that you should only take one dose per day.
• Consider setting a timer or an alarm.
• You might find it helpful to download a medication reminder app on your smartphone.
• These strategies can help maintain your treatment schedule and ensure the optimal effectiveness of your medication.

[Note: If you have missed a medication dose and are unsure when to take the next one, consult your doctor or pharmacist immediately.]

Overdose 

Using more Breo Ellipta than prescribed by your doctor can lead to serious side effects. It is crucial to adhere strictly to the dosage your doctor recommends. While the manufacturer does not specifically report overdoses of Breo Ellipta, there have been cases of overdoses with the individual drugs it contains. Due to its inhaled form, Breo Ellipta is generally less likely to cause an overdose compared to oral forms of the same medications. However, possible overdose symptoms from fluticasone furoate, one of the components in Breo Ellipta, might include:

• Round face
• Muscle weakness
• Hyperglycemia
• Extreme fatigue
• Hypercortisolism (high cortisol levels)

Overdose symptoms of vilanterol in Breo Ellipta may include:

• Abnormal heart rhythm
• Seizures
• Tachycardia (fast heartbeat)
• Low potassium levels
• Dry mouth
• Angina (chest pain)
• High blood sugar levels
• Low blood pressure
• High blood pressure

If you accidentally take more than the recommended dose of Breo Ellipta, it’s important to act quickly and call your doctor immediately if you believe you have taken too much Breo Ellipta. They can provide guidance based on the amount you’ve taken. If you experience severe symptoms such as difficulty breathing, chest pain, or severe dizziness, call 911 or your local emergency number immediately or go directly to the nearest emergency room. Taking prompt action can help manage the effects of an overdose and ensure your safety.

[Note: If you consumed more than the recommended dose, get medical help right away or call the Poison Help line at 1-800-222-1222.]

Storage

• Store the medication in a closed container at room temperature.
• Keep it away from heat, moisture, and direct light to maintain its effectiveness.
• Ensure the medicine does not freeze.
• Keep Breo Ellipta out of the reach of children to prevent accidental ingestion.
• Do not keep medicine that is outdated or no longer needed.
• Consult your healthcare professional for guidance on how to properly dispose of unused medication.
• Keep the inhaler dry, away from heat and direct sunlight.
• Discard the inhaler either six weeks after opening or when the dose counter reads 0, whichever comes first.
• Following these storage instructions helps ensure the medication remains effective and safe for use.

[Note: Discuss with your healthcare professional about the proper disposal of any unused medicine and any questions you may have regarding its storage.]

Breo Ellipta Interactions

Breo Ellipta can interact with various medications and certain supplements, potentially causing different effects depending on the interaction. Some interactions may affect the effectiveness of Breo, while others could increase the likelihood of side effects. It is essential to be aware of these potential interactions to ensure optimal treatment outcomes and avoid adverse effects. Always discuss all medications, over-the-counter drugs, and supplements you are using with your healthcare provider to manage and monitor these interactions effectively.

Interaction with Other Medications

Breo Ellipta may interact with various medications, and while the list provided below includes some everyday interactions, it is not exhaustive. Before starting Breo, it is crucial to inform your doctor and pharmacist about all the prescription medications, over-the-counter drugs, vitamins, herbs, and supplements you are currently using. This comprehensive disclosure helps your healthcare providers identify any potential interactions and manage them proactively to prevent adverse effects. If you have any concerns or questions about how other drugs might interact with Breo, do not hesitate to consult your doctor or pharmacist for personalized advice and guidance.

Certain Antimicrobial Medications: Certain antimicrobial medications, which are used to treat infections caused by bacteria, viruses, or fungi, can interact with Breo Ellipta. When taken alongside certain antimicrobials, the levels of Breo in your body may increase, potentially leading to more frequent and more severe side effects. If you are taking any antimicrobial medications, it’s essential to discuss with your doctor the specific risks associated with using Breo. They can provide guidance on how to safely manage your medications to minimize these risks. Examples of antimicrobials that may interact with Breo include:

• Nizoral (ketoconazole)
• Norvir (ritonavir)
• Biaxin (clarithromycin)
• Sporanox (itraconazole)
• Vfend (voriconazole)
• Extina (ketoconazole)
• Xolegel (ketoconazole)

Certain Antidepressants: Taking Breo Ellipta in combination with certain antidepressants can lead to heart rhythm problems. This is because some antidepressants can interact with Breo, affecting how it is metabolized or how it functions in your body. If you are prescribed any antidepressant medications, it is crucial to discuss the potential risks and considerations with your doctor before using Breo. They can help you understand the implications and decide on the safest approach to your treatment. Examples of antidepressants that may cause interactions with Breo include:

• Monoamine oxidase inhibitors (MAOIs), such as:
  • Marplan (isocarboxazid)
  • Nardil (phenelzine)
  • Nardelzine (phenelzine)
  • Tranylcypromine
  • Emsam (selegiline)
  • Eldepryl (selegiline)
  • Zelapar (selegiline)
  • Azilect (rasagiline)
• Tricyclic antidepressants (TCAs), such as:
  • Endap (amitriptyline)
  • Anafranil (clomipramine)
  • Sinequan (doxepin)
  • Tofranil (imipramine)
  • Aventyl (nortriptyline)
  • Pamelor (nortriptyline)
  • Vivactil (protriptyline)

Other Drugs That Can Affect Your Heart Rhythm: Certain drugs can impact your heart’s rhythm by increasing your QT interval, a measure used to assess the timing of heart electrical activity. When these drugs are taken with Breo Ellipta, the risk of developing heart rhythm problems may increase. It’s crucial to discuss the potential risks with your doctor if you are taking any medications known to affect your QT interval. Your doctor can provide guidance on how to safely use Breo in conjunction with these medications and monitor for any adverse effects. Examples of medicines that can extend the QT interval and may interact with Breo include:

• Antiarrhythmics (heart rhythm) medications, such as:
  • Cordarone (amiodarone)
  • Nextrone (amiodarone)
  • Pacerone (amiodarone)
  • Betapace (sotalol)
  • Betapace AF (sotalol)
  • Sorine (sotalol)
• Antimicrobials, such as:
  • Cipro (ciprofloxacin)
  • Cipro XR (ciprofloxacin)
  • Erythrocin (erythromycin)
  • Nizoral (ketoconazole)
  • Extina (ketoconazole)
  • Xolegel (ketoconazole)
• other medicines, such as:
  • Imitrex (sumatriptan)
  • Zomig (zolmitriptan)
  • Dolophine (methadone)

Certain Blood Pressure and Heart Medications: Certain blood pressure and heart medications, specifically beta-blockers, can interact negatively with Breo Ellipta. Beta-blockers are used to manage blood pressure and heart conditions but can counteract the effects of Breo. This interaction can lead to the constriction (narrowing) of blood vessels in your lungs, making breathing more difficult and potentially increasing your risk of asthma attacks. If you are prescribed beta-blockers, it’s important to discuss this with your doctor to understand the risks and manage your medications to avoid exacerbating respiratory issues. Examples of beta-blockers that may interact with Breo include:

• Coreg (carvedilol)
• Normodyne (labetalol)
• Trandate (labetalol)
• Corgard (nadolol)
• Hemangeol (propranolol)
• Inderal (propranolol)
• InnoPran XL (propranolol)

Certain Diuretics: Certain diuretics, specifically non-potassium-sparing diuretics, can interact with Breo Ellipta when used concurrently. These types of diuretics are used to treat heart and blood pressure conditions but may cause potassium to be excreted from the body through urine. When potassium levels become too low, it can lead to significant heart issues, including abnormal heart rhythms that may be too fast, too slow, or irregular. If you are taking these diuretics, it’s crucial to discuss this with your doctor, as the combination with Breo could affect your heart health. Examples of non-potassium-sparing diuretics include:

• Diuril (chlorathiazide)
• Apo-Hydro (hydrochlorothiazide)
• Aquazide (hydrochlorothiazide)
• Microzide (hydrochlorothiazide)
• Bumex (bumetanide)
• Lasix (furosemide)
• Demadex (torsemide)

Breo Use with Other Drugs

When managing chronic obstructive pulmonary disease (COPD) or asthma, your doctor may prescribe Breo Ellipta along with other medications. It’s common in the treatment of these respiratory conditions to use a combination of long-term control medications and short-acting, or rescue, medications.

Long-term medications like Breo are used regularly to maintain control of chronic symptoms and prevent exacerbations. They are not suitable for treating acute asthma attacks or sudden COPD flare-ups and are typically limited to once or twice daily use based on the prescribed regimen.

Rescue medications, on the other hand, are short-acting drugs designed to quickly relieve symptoms during an acute episode. These inhalers can be used multiple times throughout the day as needed to manage sudden breathing difficulties due to COPD flare-ups or asthma attacks. To complement the treatment with Breo, your doctor might also prescribe the following types of medications:

• Long-acting muscarinic antagonists (LAMAs)
  • Tudorza Pressair (aclidinium)
  • Seebri Neohaler (glycopyrrolate)
  • Longhala Magnair (glycopyrrolate)
  • Spiriva HandiHaler (tiotropium)
  • Spiriva Respimat (tiotropium)
  • Incruse Ellipta (umeclidinium)
• Short-acting beta2-adrenergic agonists
  • Diuril (chlorathiazide)
  • Apo-Hydro (hydrochlorothiazide)
  • Aquazide (hydrochlorothiazide)
  • Microzide (hydrochlorothiazide)
  • Bumex (bumetanide)
  • Lasix (furosemide)
  • Demadex (torsemide)

Use with Incruse Ellipta: The combination of Breo Ellipta and Incruse Ellipta is specifically utilized in the treatment of chronic obstructive pulmonary disease (COPD). Incruse Ellipta is a brand-name medication that includes umeclidinium bromide, which is a long-acting muscarinic antagonist (LAMA). Breo Ellipta, on the other hand, combines an inhaled corticosteroid (ICS), fluticasone fumerate, with a long-acting beta2-adrenergic agonist (LABA), vilanterol trifenatate.

Using Breo and Incruse Ellipta together introduces three types of therapeutic agents into the treatment regimen: an LABA, a LAMA, and an ICS. This triple therapy approach can be beneficial for individuals whose COPD symptoms are not adequately controlled by one or two medications alone. For a more integrated solution, the brand-name medication Trelegy Ellipta combines these three types of drugs into a single inhaler, which is also used once daily for the management of COPD. This approach aims to simplify treatment regimens while effectively controlling the symptoms of COPD.

Use with Spiriva: Breo Ellipta, containing an inhaled corticosteroid (fluticasone fumerate) and a long-acting beta2-adrenergic agonist (LABA, vilanterol trifenatate), can be used in conjunction with Spiriva, which contains tiotropium bromide, a long-acting muscarinic antagonist (LAMA). This combination covers three major classes of respiratory drugs: LABA, LAMA, and ICS. This triple therapy is particularly useful for individuals whose symptoms of COPD or severe asthma are not adequately controlled by mono or dual therapy.

Use with Albuterol: While Breo is intended for long-term management of COPD and prevention of asthma attacks, it is not suitable for immediate relief during an acute flare-up or asthma attack. For such urgent situations, albuterol, a short-acting beta2-adrenergic agonist (SABA), is recommended. Albuterol works quickly to relieve symptoms of COPD flare-ups and asthma attacks. Patients may use albuterol in conjunction with Breo to address sudden symptoms effectively while maintaining long-term control with Breo.

This strategic use of medications ensures both preventive care through Breo and immediate relief through albuterol, offering a comprehensive approach to managing respiratory conditions effectively. Always consult with healthcare providers to tailor the medication regimen that best suits individual health needs and conditions.

[Note: This isn’t a complete list, and there could be other drugs that interact with Breo Ellipta. Make sure to tell your doctor about any prescription, over-the-counter, or herbal products you’re taking.]

Breo Ellipta Alternatives

• Incruse Ellipta (umeclidinium)
• Spiriva Respimat (tiotropium bromide)
• Spiriva Handihaler (tiotropium bromide)
• Stiolto Respimat (olodaterol-tiotropium)
• Trelegy Ellipta (fluticasone-umeclidinium-vilanterol)
• Anoro Ellipta (umeclidinium-vilanterol)
• Tudorza Pressair (aclidinium)
• Combivent Respimat (ipratropium-albuterol)
• Duaklir Pressair (aclidinium-formoterol)
• Symbicort (budesonide-formoterol)
• Zithromax (azithromycin)
• Advair Diskus (fluticasone-salmeterol)
• Daliresp (roflumilast)
• N-acetylcysteine
• Theophylline ER
• Yuperli (revefenacin)
• Bevespi Aerosphere (formoterol–glycopyrrolate)
• Lonhala Magnair (glycopyrrolate)
• Breztri Aerosphere (budesonide–formoterol–glycopyrrolate)
• Proair HFA (albuterol)
• Atrovent HFA (ipratropium)
• Ventolin HFA (albuterol)
• Ipratropium–albuterol nebulizer solution
• Albuterol nebulizer solution
• Perforomist (formoterol)
• Serevent Diskus (salmeterol)
• Brovana nebulizer solution (arformoterol)
• Prednisone

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.] 

Frequently Asked Questions

How long does it take for Breo Ellipta to work?

Breo starts to act as soon as you inhale it, but the noticeable improvement in breathing may not be immediate because it is designed for long-term management of the conditions. It gradually enhances lung function and helps to prevent future flare-ups of COPD and asthma attacks.

Most users begin to experience easier breathing approximately 15 minutes after taking a dose of Breo, indicating the onset of its fast-acting benefits.

Is Breo hard on the heart?

Breo Ellipta, which contains fluticasone and vilanterol, has the potential to affect the heart’s rhythm, a condition known as QT prolongation. Although it is uncommon, QT prolongation can lead to serious, and sometimes even fatal, fast or irregular heartbeats. Other symptoms associated with this condition include severe dizziness and fainting, which require immediate medical attention. It is important to be aware of these risks and discuss any concerns with your healthcare provider to ensure safe use of this medication.

Does Breo have albuterol in it?

No, Breo Ellipta does not contain albuterol. Both Breo Ellipta and albuterol sulfate are used to treat asthma and COPD, but they contain different active ingredients. Albuterol sulfate is a short-acting beta-agonist (SABA) used primarily for quick relief of asthma symptoms or during a COPD flare-up, whereas Breo is used for long-term management of these conditions and not for immediate symptom relief.

How long can you stay on Breo?

Breo Ellipta is intended for long-term management of asthma and chronic obstructive pulmonary disease (COPD). It acts primarily as a preventative medication, meaning it helps to control and prevent symptoms as long as you continue to use it regularly. Unless advised by your doctor to discontinue its use, it’s important to keep taking Breo Ellipta to prevent the return of symptoms. Your healthcare provider will monitor your condition and make adjustments to your treatment as necessary.

Does Breo cause weight gain?

Weight gain is a potential, though rare, side effect of taking Breo Ellipta, primarily due to its content of fluticasone furoate, an inhaled corticosteroid (ICS). Fluticasone can cause fluctuations in cortisol levels, leading to hypercorticism (high cortisol levels) and potentially adrenal suppression (low cortisol levels). These hormonal changes can sometimes result in weight gain, among other side effects.

What happens if you don’t rinse your mouth after an inhaler?

Rinse your mouth after using a steroid inhaler, such as Breo Ellipta, is crucial. Failing to do so can leave residual medication in your mouth and throat, which isn’t absorbed by your lungs and can lead to side effects. One common issue is the development of oral thrush, a fungal infection in the mouth. Rinsing helps to clear away any leftover medicine, reducing the risk of this and other potential side effects.

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